Individual
MR. BRIAN FOSTER I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2183
Mailing address
322 DUNCAN DR, ATOKA, TN 38004-7875
(901) 837-9583
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000135168
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 15231
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05656310
—
MS
01
—
1316266414
CHAMPUS/HUMANA TRICARE
—
05
—
1521696
—
TN
05
—
186483001
—
AR
01
—
4274309
BLUE CROSS
TN
01
—
P00907123
RAILROAD MEDICARE
TN
Enumeration date
05/28/2010
Last updated
06/09/2011
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